title: Conservative treatment of chronic pancreatitis.
abstract: BACKGROUND
  Chronic pancreatitis is a progressive inflammatory disease giving rise to several complications that need to be treated accordingly. Because pancreatic surgery has significant morbidity and mortality, less invasive therapy seems to be an attractive option.
  
  
  OBJECTIVE
  This paper reviews current state-of-the-art strategies to treat chronic pancreatitis without surgery and the current guidelines for the medical therapy of chronic pancreatitis.
  
  
  RESULTS
  Endoscopic therapy of complications of chronic pancreatitis such as pain, main pancreatic duct strictures and stones as well as pseudocysts is technically feasible and safe. The long-term outcome, however, is inferior to definitive surgical procedures such as resection or drainage. On the other hand, the medical therapy of pancreatic endocrine and exocrine insufficiency is well established and evidence based.
  
  
  CONCLUSIONS
  Endoscopic therapy may be an option to bridge for surgery and in children/young adolescents and those unfit for surgery. Pain in chronic pancreatitis as well as treatment of pancreatic exocrine insufficiency follows established guidelines.
authors.affiliation: Gastroenterology and Hepatology, Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden. matthias.lohr@ki.se
authors.forename: J-Matthias
authors.initials: JM
authors.lastname: Löhr
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Haas
authors.forename: Fredrik
authors.initials: F
authors.lastname: Lindgren
authors.forename: Lars
authors.initials: L
authors.lastname: Enochsson
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Hedström
authors.forename: Fredrik
authors.initials: F
authors.lastname: Swahn
authors.forename: Ralf
authors.initials: R
authors.lastname: Segersvärd
authors.forename: Urban
authors.initials: U
authors.lastname: Arnelo
mesh_terms: D004724:Endoscopy; D056947:Enzyme Replacement Therapy; D010188:Exocrine Pancreatic Insufficiency / Q000628:therapy; D006801:Humans; D010146:Pain / Q000209:etiology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D011859:Radiography